Rapid Review 583

Question 1

pupil accommodates but doesn’t react to light

Answer 1

Argyll Robertson pupil (neurosyphilis –tertiary)

Question 2

“ascending paralysis” rapidly progressive leg weakness that ascends following GI/upper respiratory infection

Answer 2

Guillain-Barre syndrome (autoimmune acute inflammatory demyelinating polyneuropathy)

Question 3

rash on palms and soles

Answer 3

Coxsackie A, 2* syphilis, Rocky Mountain Spotted fever

Question 4

Recurrent colds, unusual eczema (on trunk not on flexture), high serum IgE

Answer 4

hyper-IgE syndrome or Job’s syndrome (neutrophil chemotaxis abnormality)

Question 5

red “currant jelly” sputum in alcoholic or diabetic pts

Answer 5

Klebsiella pneumoniae

Question 6

Currant jelly stool

Answer 6

Intussuception

Question 7

red brick/brown sputum

Answer 7

Strept pneumoniae

Question 8

Red urine in the morning, fragile RBCs

Answer 8

Paroxysmal nocturnal hemoglobinuria

Question 9

Red, itchy, swollen rash of nipple/areola

Answer 9

Paget’s dz of the breast (represents underlying neoplasm)

Question 10

Renal cell carcinoma (bilateral), hemangioblastoma, angiomatosis, pheochromocytoma

Answer 10

von Hippel-LIndau dz (dominant tumor suppressor gene mutation)

Question 11

Resting tremor, rigidity, akinesia, postural instability

Answer 11

Parkinson’s dz (nigrostriatal dopamine depletion)

Question 12

Retinal hemorrhage with pale centers

Answer 12

Roth’s spots (bacterial endocarditis)

Question 13

severe jaundice in neonate

Answer 13

Crigler-Najjar syndrome (congenital unconjugated hyperbilirubinemia)

Question 14

Severe RLQ pain with rebound tenderness

Answer 14

McBurney’s sign (appendicitis)

Question 15

short stature, inc incidence of tumors/leukemia, aplastic anemia

Answer 15

Faconi’s anemia (genetic loss of DNA crosslink repair; often progress to AML)

Question 16

Single palm crease

Answer 16

Simian crease (Down syndrome)

Question 17

situs inversus, chronic sinusitis, bronchiectasis, infertility

Answer 17

Kartagener’s syndrome (dynein arm defect affecting cilia)

Question 18

skin hyperpigmentation

Answer 18

Addison’s dz (primary adrenocortical insuffciency causes inc ACTH and alpha-MSH production)

Question 19

slow, progressive muscle weakness in boys

Answer 19

Becker’s muscular dystrophy (X-linked missense mutation in dystrophin; less severe than Duchenne’s)

Question 20

small, irregular red spots on buccal/lingual mucosa with blue-white centers

Answer 20

Kolik spots (measles, rubeola virus)

Question 21

Smooth, flat, moist white lesions on genitals

Answer 21

Condylomata lata (secondary syphilis)

Question 22

splinter hemorrhages in fingernails

Answer 22

Bacterial endocarditis

Question 23

Strawberry tongue

Answer 23

Scarlet fever (/w rash), Kawasaki dz, toxic shock syndrome

Question 24

streak ovaries, congenital heart dz, horseshoe kidney, cystic hygroma at birth

Answer 24

Turner syndrome (45XO, short stature, webbed neck, lymphedema)

Question 25

sudden swollen/painful big toe joint, tophi

Answer 25

gout/podagra (hyperuricemia)

Question 26

swollen gums, mucous bleeding, poor wound healing, spots on skin

Answer 26

scurvy (vitamin C deficiency; can’t hydroxylate proline/lysine for collage synthesis)

Question 27

swollen, hard, painful finger joints

Answer 27

Osteoarthritis (osteophytes on PIP -Bouchard’s nodes) DIP -Heberden’s nodes

Question 28

systolic ejection murmur (crescendo-decrescendo)

Answer 28

Aortic valve stenosis

Question 29

Thyroid and parathyroid tumors, pheochromocytoma

Answer 29

MEN 2A (autosomal dominant ret mutation)

Question 30

Thyroid tumors, pheochromocytoma, ganglioneuromatosis

Answer 30

MEN 2B (autosomal dominant ret mutation)

Question 31

Toe extension/fanning upon plantar scrape

Answer 31

Babinski sign (UMN lesion)